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PARE0009 Factors Influencing the Use of a Self-Management Care Booklet for Patients with Rheumatoid Arthritis
  1. A. Claassen1,
  2. T. Vliet Vlieland2,
  3. J. Meesters3,
  4. S. Pellegrom3,
  5. J. Noordman4,
  6. B. Kaarls-Ohms5,
  7. A. Peters6,
  8. J. Vooijs7,
  9. G. Willemsen-de Mey8,
  10. C. van den Ende1
  1. 1Department of Rheumatology, Sint Maartenskliniek, Nijmegen
  2. 2Department of Orthopaedics
  3. 3Department of Rheumatology, Leiden University Medical Center, Leiden
  4. 4Netherlands Institute for Health Services Research, Utrecht
  5. 5Patient representative, Leiden
  6. 6Patient research partner, Nijmegen
  7. 7Patient representative, Katwijk
  8. 8Patient representative, Nijmegen, Netherlands


Background Patients with Rheumatoid Arthritis (RA) face multiple treatments and have contact with multiple healthcare providers during the course of their disease. A care booklet, consisting of information and tools to set and monitor treatment goals can support patients to be an active participant in the management of their disease. To optimize the implementation of a care booklet, it is important to get insight into factors influencing the use of a care booklet.

Objectives The aim of this study is to identify factors that are associated with the use of a self-management care booklet in RA-patients.

Methods The care booklet was distributed among patients visiting the departments of rheumatology of two hospitals in two regions of the Netherlands. An a-selective sample of 1000 RA-patients received the care booklet by mail; another a-selective sample of 1000 patients received an information letter with the option to order the care booklet. Four months after distribution, a random sample of 810 patients (stratified by hospital and distribution method) received a questionnaire on the use of the booklet and potential influencing factors. The use of the booklet was defined as having read it, making notes in the booklet and/or discussing it with a healthcare provider. Potential influencing factors included social-demographic characteristics, medication use, disease activity and duration, activity limitations, self-efficacy, illness perceptions, distribution strategy and educational needs. Based on univariate analysis, variables for a multilevel logistic regression model were selected. Region was included as random effect.

Results In total 370 patients (46%) returned the questionnaire. Mean (SD) age of the patients was 65.1 (11.9) with the majority being woman (68%). The care booklet was used by 77 (21%) patients. No relation was found between distribution method and use of the care booklet. Age, cohabitation, activity limitation, educational needs and beliefs about RA having a fluctuating disease course, were univariately associated with the use of the care booklet (p<0.05). Identified factors independently associated with the use of the care booklet were: relatively high level of activity limitations (OR =2.36, CI 1.26–4.42), cohabiting (OR =2.21, CI 1.04-4.70), beliefs about RA having a fluctuating disease course (OR =1.84, CI 1.05–3.22) and younger age (OR =0.41, CI 0.22–0.76).

Conclusions A low-cost self-management tool is used by about 1 out of 5 RA-patients. Our findings provide starting points to optimize further implementation strategies of a care-booklet by targeting specific subgroups of patients or by integrating the care booklet in the routine care. Further research should focus on the (cost)-effectiveness of care-booklet.

Acknowledgements This project was financially supported by the Dutch Arthritis Foundation (Reumafonds)

Disclosure of Interest None declared

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